No hepatologist, even at any of the major medical centers in the United States, has access to a sufficient number of patients to evaluate controversial or proposed new methods of treating acute hepatic insufficiency. The Acute Hepatic Failure Study Group consists of investigators who have combined for cooperative studies of methods of therapy. The Group proposes the evaluation of corticosteroids in acute hepatic failure at 15 centers seeing sufficient numbers of patients to answer the question whether this adjunct to management of fulminant viral hepatitis and acute failure of other etiologies has any influence upon survival. Used on virtually a world- wide basis almost since the first report of benefit in 1952, there has never been any controlled study with a sufficient number of patients to demonstrate its influence upon survival. Lack of benefit or even potential harm are now suggested with sufficiet frequency by leading hepatologists that a controlled study may ethically be done. The participating investigators estimate that they can randomize a sufficient number of cases (120) in a 30-month period to determine whether corticosteroids in the doses usually used in the past have any influence on early (as judged by survival) and long-term (as judged by occurrence of chronic liver disease) outcome.